서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

혈관질환 정보관리 시스템

김동익,김덕경,허세호,이병붕,김용신,김은숙,문지영,도영수,신성욱,김동수,김만태,진재욱,김용신 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1

As medical technology progresses rapidly, there is a rise in the average age along with the Korean dietary lifestyle becoming more westernized, which leads to an increase in the number of vascular disease patients in Korea. Thus, we need to manage the medical information of a disease systematically in order to diagnose and treat constructively. However, since there has been no standardized method of man agement to date, a great deal of information could not be properly utilized nor studied. Therefore, the departments of Cardiology, Radiology and Neurology of Samsung Seoul Hospital recently got together to develop an information management system called the Vascular Data System. This program was developed to be run on win98 O/S, upper Pentium Ⅲ, and upper 128 MB Memory, and its source code is Dephi 4.0. It was configured for the user to set the configurations as well as do a variety of search and analysis. If this program were to be updated continuously, it may be used extensively as well as in various parts of clinical research activities.

感冒처방 晴崗醫鑑 '加味普正散'의 의학역사적 이해

이병욱(Byung-Wook Lee),김동율(Dong-Ryul Kim),차웅석(Wung-Seok Cha) 한국의사학회 2011 한국의사학회지 Vol.24 No.2

This paper aims to find out the unique Oriental Medical characteristics of the prescription Gami-Bojeongsan(加味普正散), which can only be found in 『Cheong-gang Euigam(晴崗醫鑑』 and the records of diagnosis by Kim Yeong Hoon. First, clues regarding Gami-Bojeongsan (加味普正散) in 『Cheong-gang Euigam(晴崗醫鑑)』 and the records of diagnosis by Kim Yeong Hoon have been collected, and then the origin of Gami-Bojeongsan(加味普正散) has been studied. Moreover, changes of prescriptions for common cold in East Asian Medicine have been looked into from historical perspective, and their connection to Gami-Bojeongsan(加味普正散) has also been researched. Lastly, connection of prescriptions for common cold found in royal records of the Chosun Dynasty to Gami-Bojeongsan(加味普正散) has been confirmed. The results are as follow: 1) Gami-Bojeongsan(加味普正散) is a most frequently used prescription in the records of diagnosis by Kim Yeong Hoon, and was used mostly in winter. It includes various modified versions. 2) Prescriptions that adopt Cyperi Rhizoma(香附子) as the sovereign medicinal, such as Gami-Bojeongsan(加味普正散), include Hyangsosan(香蘇散) of 『Hejijufang(和剂局方)』 and Hyang-gal-tang (香葛湯) of 『Dexiaofang(得效方)』 Hyang-gal-tang(香葛湯) is thought to have adopted Korean characteristics through Dong-Eui-Bo-Gam(東醫寶鑑) and 『Je-Jung-Shin-Pyeon』 and have continued its existence until it reached Gami-Bojeongsan(加味普正散) 3)These characteristics can be found in the royal records of the Chosun Dynasty, and also in Shin-Su- Tae-Eul-San(神授太乙散) of 『Euibang-Yuchui (醫方類聚)』.

65세 이상의 노령층에서 고지혈증의 위험요인

김용배,장원기,황보영,김화성,안규동,이병국,이용진,김세훈,김승수,김승훈,김영록,김웅빈,이성수 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.1

..

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

HID 램프용 디지털제어 전자식 안정기에 관한 연구

김영동,강원찬,김남오,김형곤,김병철 조선대학교 에너지.자원신기술연구소 2004 에너지·자원신기술연구소 논문지 Vol.26 No.1

In this paper, digitally controlled electronic ballast for the HID lamps driven by proposed frequency conversion method is described. This electronic ballast consists of a buck converter, a low frequency square wave full bridge inverter, a high voltage pulse generator for the lamp ignition, an over current protection circuit and an 8-bit microcontroller. The fuzzy logic digital control operation is carried out by the 8-bit microcontroller. In spite of the limited control bandwidth caused by low operation speed of the 8-bit microcontroller, the good control performance for the constant lamp current in the warm-up period is obtained using the proposed frequency conversion driving method. The HID lamp is controlled in a constant current mode during the lighting warm up process and is controlled in a constant power mode during lighting steady state. A controlled variable power mode is used to extend the lamp lifetime.

捻轉法이 竝行된 鍼刺戟 및 電鍼刺戟이 鎭痛效果에 미치는 影響

Park, Dong-Seok,Kim, Ji-Hoon,Min, Byung-Il,Oh, Soo-Myung 경희대학교 동서의학연구소 1999 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.1999 No.1

Dong-Seok Park¹, Ji-Hoon Kim¹ and Byung-Il Min, Soo-Myung Oh,³¹Department of Acupuncture and Moxibustion, College of Medicine, ²Department of Physiology, College of Medicine, And ³East-West Medical Research Institute, Kyung Hee University,Seoul, Korea. Analgesic Effect of Manual Acupuncture and Electroacupuncture combined with Twirling Method. Proceeding of International Symposium on East-West Medicine Seoul. 187-200, 1999.-Twirling the needle (TN) is one of several needing methods frequently used for acupuncture in the oriental medicine. The present study was conducted to see if TN enhanced the antinociceptive effect produced by plain-or electroacupuncture in the rat tail flick test. Rats (Sprague-Dawley, 200-300g)lightly anesthetized with thiopental sodium(40mg/kg, i.p.) were used in the tail-flick test. The basal reaction time for tail-flick was 2 sec. For "plain" acupuncture(PA), a needle was inserted for 20 min into a Chock-samni (ST36) acupuncture point which (is located at the anterior tibial muscle and about 10mm below the knee joint). For electroacupuncture(EA), train-pulses(3 Hz,0.3-ms pulse width, 0.2-0.3mA) were applied to the inserted needle for the period of insertion. For combining TN with either PA or EA, TN was performed during the each acupuncture period. Two methods for TN were used; twirling 3 times for 1 second persisted for 1 min in every 5 mins(long-duration and long-interval;LDLI) and twirling 3 times for 1 second persisted for 10 sec in every 1 min(short-duration and short-interval;SDSI). PA and EA produced an increase in tail flick latency (TFL); peak increases were 21.3±5.1% and 42.1±17.3% of the pre-acupunture control, respectively, and occurred immediately after cessation of 20min-acupuncture. Performing TN combined with PA increased TFL more than PA itself by showing a greater peak increase in TFL when performed with a SDSI-TN than with a LDLI-TN(60.6±12.5% and 42.7±22.7% of the pre-acupuncture control, respectively). Performing TN combined with EA also increased TFL more than EA itself and a greater peak increase in TFL was observed with a SDSI-TN as compared to a LDLI-TN(77.5±13.8% and 67.3±14.0% of the pre-acupuncture control, respectively). These results indicate that TN enhances both PA-and EA-produced antinociception where an greater enhanced antinociception than a LDLI-TN. It is suggested that performing a SDSI-TN combined with EA seems to be one of the most effective ways to produce analgesia.

소규모사업장 용접근로자들의 소음·용접흄·망간 노출에 관한 연구

김동구,문덕환,이채관,박명희,함성애,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objective : This study was conducted for the purpose of investigating the level exposure of welders to noise, welding fume and Manganese(Mn) related to this process. Methods and Material : All subjects in this study were welders engaged in CO2 arc and coated arc welding process especially in small-scale enterprises classified by type of manufacture of ship building, repairing and of other fabricated metal products, which is located in Gimhae and Milyang of Kyeongsang province in south Korea. Air sampling of welding fume was measured, shipped and analyzed on the basis of national institute for occupational safety and health(NIOSH) method in U.S. and work environment measurement method established in south Korea. To measure Noise in the work environment, Noise dosimeter was used on the basis of work environment measurement method established in south Korea. Result : This study was performed during a period from January, 2000 to December, 2001 and Results were as follows: 1. Noise level measured in this work environment was higher than national criteria for permissible exposure limit on health examinations related to hearing loss. 2. The concentration of welding fume and Mn in manufacture of ship building and repairing was higher than those in manufacture of other fabricated metal products. 3. In conditions of existing in ventilation system installed and operated, the concentration of welding fume and Mn was slightly lower than those of not existing. 4. In conditions of existing in sufficient air supply from out door into the work place relied on natural exhaust system, the concentration of welding fume and Mn was slightly lower than those of in not sufficient. 5. In all subjects, a rate of wearing ear plug and respiratory mask for dust and fume was lower than that of not wearing. Conclusion : According to above results, this study suggests that more positive work environment managements such as the use of portable local ventilation system, the supply of highly qualified personal protective equipment, and consecutive education and training related to health protection should be need to acquire suitable health protection program for welders engaged in small-scale enterprises in Korea.

직업적 노출에 의한 스티븐스-존슨 증후군에서 트리클로로에틸렌의 노출수준 : 3예의 사례와 문헌고찰을 중심으로

이선웅,김은아,김대성,고동희,강성규,김병규,김민기 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: TCE는 심각한 전산적 피부염과 관련 있는 것으로 몇몇 사례들을 통해서 보고되어 왔으나,기존의 사례 보고들에서 노출평가가 수행된 사례는 드물었고 추정되는 노출량 역시 매우 다양하였다. 본 연구에서는 TCE 노출에 의한 것으로 판단되는 스티븐스-존슨 증후군 3예를 확인하고 각 사례들에 대한 작업재연을 통해 노출수준을 추정하였으며,이를 통해 TCE의 직업적 노출수준과 스티븐스-존슨 증후군을 포함하는 전신적 박탈성 피부염 발생의 관계를 이해하고자 하였다. 증례: 사례 1은 24세 필리핀인 여자로 TCE를 이용한 탈지작업을 시작한 35일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스 존슨 증후군과 독성간염으로 진단되었고 증상발생 39일 간부전으로 사망하였다. 증상발생 전 약물 복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준 은 TWA 21.9 ppm과 32.3 ppm이었다. 사례 2는 47세 한국인 남자로 TCE를 이용한 탈지 작업을 시작한 20일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 중독성 표피괴사증 또는 스티븐스 -존슨 증후군, 전격성간염 및 동반된 패혈증으로 진단되었고 증상발생 42일 간부전 및 패혈증으로 사망하였다. 증상발생 전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 30.1 ppm이었으며 세척조 주위의 지역시료는 TWA 116.5 ppm∼229. 7 ppm 이었다. 사례 3은 22세 베트남인 여자로 TCE를 이용한 탐지작업을 시작한 30일 후 발전을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스-존슨 증후군 및 동반된 독성간염으로 진단되었고 증상발생 37일 증세 호전되어 퇴원하였다. 증상발생전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 107.2 ppm이었다. 고찰: TCE에 노출된 일부의 사람들에서 노출 후 2주에서 5주 사이에 심각한 급성 간염이 동반되는 스티븐스­존슨 증후군이 발생할 수 있음을 확인 하였고,이번의 연구결과와 기존의 연구를 종합 할 때 TCE에 대한 감수성이 있는 사람의 상당수는 노출기준 이상의 고 노출에 노 출 후 스티븐스- 존슨 증후군이 발생함을 확인할 수 있었다. 따라서. TCE에 대한 고 노출을 막기 위해 TCE 세척작업에 대한 작업환경 확인과 개선이 우선적으로 필요하며,동시에 노출 후 증상발생기간의 일관성과 노출기준 이하의 저 노출에서의 감작 가능성을 배제할 수 없음을 고려하여,작업시작 후 1개월경의 특수건강검진 역시 고려되어야 할 것으로 판단된다. Back ground: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens-Johnson syndrome. Case report: Case 1. A 24-year-o1d Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (Personal exposure level) with TWA. Case 2. A 47-year-o1d Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset ofthe first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (Personal exposure level) and 116.5∼229.7 ppm (area exposure level close to the degreasing rnachine) with TWA. Case 3. A 22-year-old Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (Personal exposure level) with TWA. Discussion: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

신경섬유종증-제 2형의 진단과 치료 : 16례의 임상경험 Experience of 16 Cases

김정은,백선하,김종수,이상형,오창완,김동규,정희원,김현집,조병규,한대희,최길수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

Neurofibromatosis type 2(NF-2) is a dominantly inherited disorder characterized by the occurrence of bilateral acoustic neurinomas and the frequent association of other central nervous system tumors. We present a retrospective review of 16 patients with NF-2 who were treated at our hospital from 1984 to 1995 in 13 cases, the diagnoses of Nf-2 were based on the criteria developed at the Consensus Development Conference of National Institute of Health in the United States, and in another 3 cases. the criterias of NF-2 were not fully satisfied, but the diagnoses of NF-2 were highly suspected. The average age of the patients was 27.6 years, ranging from 13 years to 56 years. The most common symptom was hearing difficulty : intervals between symptom onset and deafness ranged from 8 months to 6 years(mean : 2.9 years) One family of NF-2 was documented consisting of a sister a brother and their mother. Nine patients underwent operations on unilateral acoustic neurinomas : these were subtotally removed in eight patients and totally in one patient Among these patients five were deaf on the ipsilateral side at surgery. Among the other four patients with useful hearing before surgery, hearing was preserved to preoperative status in two patients. Four patients with diagnoses of meningioma, received operations to relieve mass effect with subtotal removal in two patients and total removal in the other two. Early diagnosis and treatment are the most important in the management planning of patients with NF-2 for reasons of early manifestation and rapid progression of the disease.